Transforming IBD care: the future of personalized therapy through multi-omics and pharmacogenomics.

Introduction: Inflammatory bowel disease (IBD) treatment remains challenging, with many patients experiencing suboptimal responses despite advances in therapies. This necessitates more precise and personalized approaches.

Areas covered: A literature search was conducted using Embase, Scopus, and PubMed (January 2000-March 2024) with keywords such as 'inflammatory bowel disease,' 'pharmacogenomics,' 'multi-omics,' and 'multi-omics.' This review discusses (1) key pharmacogenomic markers influencing drug metabolism, efficacy, and toxicity; (2) the role of multi-omics (genomics, proteomics, metabolomics) in elucidating IBD pathogenesis and predicting therapeutic outcomes; and (3) emerging technologies such as AI-driven predictive models and organoids. Challenges in translating these tools into clinical practice - including cost, data standardization, and workflow integration - are critically examined.

Expert opinion: Integrating pharmacogenomics with multi-omics holds transformative potential for IBD care. While TPMT genotyping exemplifies current clinical utility, future frameworks will require harmonized multi-omic data to guide therapy selection. Key barriers include high costs of omics profiling, interpretative complexity, and clinician training gaps. Collaborative efforts among researchers, clinicians, and policymakers are essential to validate biomarkers, standardize methodologies, and implement cost-effective assays. Prioritizing real-world studies and AI-powered decision-support tools will accelerate the shift from trial-and-error to personalized IBD management.